Provider Demographics
NPI:1215973961
Name:WEISS, GARY B (PHD, MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:B
Last Name:WEISS
Suffix:
Gender:
Credentials:PHD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:501 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4219
Practice Address - Country:US
Practice Address - Phone:281-332-7505
Practice Address - Fax:281-332-7616
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0075207RX0202X, 207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135570304OtherCSHCN
TX135570307Medicaid
TX135570301Medicaid
TX135570303Medicaid
TX135570310Medicaid
TX135570309Medicaid
TX8R1585OtherBLUE CROSS OF TEXAS
TX8R1585OtherBLUE CROSS OF TEXAS
C23307Medicare UPIN
TX135570310Medicaid
TX8J1416Medicare PIN
TX87X851Medicare PIN
TX110034496Medicare PIN
TX401030YY6DMedicare PIN